BOOK REVIEWS 93

research is limited. In this context, Dr Steinberg’s excellent book is timely and

nudges the psychiatry of adolescence towards its “coming of age”.

The field of adolescent psychiatry is covered comprehensively, with emphasis on social and developmental aspects, and the cohesion of the conceptual and practical aspects is one of the main strengths of the book. It will not disappoint those looking

for a readable, painstakingly researched and well thought-out account of the assessment and diagnosis of disturbed adolescents, the range and development of

problems and their management. The views expressed are up-to-date and authorita- tive, displaying modesty and compassion. The clinical psychiatric model is given

pride of place and eclecticism is advocated strongly. The lucid exposition of this

approach should be of particular value to psychiatrists faced with the difficult task of choosing the most effective model for personal practice and the organisation of

services. The author brings out clearly how the clinical psychiatric approach, with its reliance on the diagnostic assessment of the individual’s disorder, enables both psychiatric and non-psychiatric problems to be identified and intervention planned

reasonably systematically, with clarification of the contribution to be made by both the psychiatric team and other professional workers. This facilitates the psychiatrist’s consultative role which is given appropriate emphasis throughout the book.

Many of the practical issues that can cause unease in inter-disciplinary work with adolescents and generate staff disputes, such as the use of authority with young

people and the value of medication, are tackled in a balanced and constructive

fashion. For example, in discussing the role of family therapy in adolescent

psychiatry, the author argues that it should have “an important place alongside several alternative styles of treatment” and that, in general, the clinical team needs to

use good ideas from a number of sources in a pragmatic way. In places, the book is

marred by being rather slow-paced and those not engaged actively in adolescent psychiatry may be tempted, regrettably, to by-pass some sections of the chapters concerned with the emergence of problems, unaware perhaps of the significance of

these issues in day-to-day work with adolescents. Most of the illustrations add little to

the text and several seem unnecessarily complex. Otherwise, there is very little to criticize. There is a substantial list of references and the book is well indexed.

C.Wi and Adolescenr Pq~hiatric ,Vursin~. Teresa R. Wilkinson. Oxford: Blackwell

Scientific Publications, 1983. Pp. 291. E7.50.

At last a book written by a nurse that must stimulate the imagination of anyone who

has ever worked with young people. The practical common sense approach illustrates graphically the author’s long

experience of work with disturbed youngsters and whilst intended for nurses it is sound reading for disciplines in all services.

The special problems associated with nursing the disturbed adolescent are well presented and the solutions, usually found only through long experience, are clearly described in a way which will stimulate good management practice.

94 BOOK REVIEWS

I was particularly impressed by the text related to aggression and limit setting

which is approached with great honesty and explained with clarity and consistency- those qualities so essential in this disturbed environment.

The nurse who chooses to work with young people faces endless demands on all his/her qualities and skills and must care enough to stay and face their confusion

whilst maintaining his or her own ability to pursue those goals which bring about therapeutic change.

I could wish that some of the text might have been expanded for at times it is a little

reminiscent of the “Aids” series. Nevertheless, schools of nursing and post basic tutors will find it invaluable in

giving the student nurse some insight into one of the major problems of their specialty

training and it should be an essential reference in all centres dealing with adolescents

or children. Joan Turner

qffective Disorders in Childhood and Adolescence-An Update. D. Cantwell and G. Carson (Eds). New York: MTP Press, 1983. Pp. 484. E27.50

This is the third in a series of books, the overall editorship of which has been in the capable hands of Professor Denis Cantwell of the University of California, Los Angeles. It includes contributions from 19 psychiatrists, psychologists, and others, who work predominantly in the U.S.A. Classification, features, assessment, causation, outcome and treatment are dealt with in considerable detail but with a refreshing clarity. The approach is in the best tradition of general clinical psychiatry. For a book written by so many individuals with different interests and backgrounds, the presentation is remarkably even and factual. There is an emphasis on quoting from published research findings and an abundance of relevant references is provided. Most chapters have something interesting to offer. The coverage of the subject is very wide. One can only pick out one or two things to mention. The description of the various possible classification systems is particularly useful especially in connection with DSM III and its derivatives. The employment of rating scales to measure depressive symptoms both in carrying out research and in the course of routine clinical work is well documented. As far as management is concerned the chapters on behaviour modification especially the one on cognitive therapy are particularly useful. This book can be heartily recommended. It is packed with useful information and doesn’t require a lot of effort to read. Most of all it set a good example in the way that perhaps child and adolescent psychiatry should be moving: towards greater objectivity, more objective and broader based research, stronger links with general psychiatry and a willingness to look at a wider range of treatments. As far as adolescent psychiatry in particular is concerned the book is especially relevant since depression appears to occur more frequently at that stage of life than in younger children. The fact that the concept of “depression” is, not surprisingly, somewhat oversold in this book only pushes one more in the direction of looking more closely at what is implied by the term and what research findings support the existence of that kind of psychiatric disorder, It i_s a pity that there are so many typographical errors in the book. Hopefully they will be eliminated in future printing.

1. Berg